Toward Health System Reform: Unveiling the Relationship Between Nurses' Psychological Empowerment and Job Embeddedness Under the Umbrella of the New Universal Health Insurance System

BACKGROUND: The new Universal Health Insurance (UHI) reforms aim to improve equity and quality of healthcare delivery; however, their sustainability depends on engagement and retention of the nursing workforce. Psychological empowerment has been identified as a key factor influencing nurses' attitudes and work-related behaviors, yet the evidence on how it relates to job embeddedness among nurses working in the early phase of UHI implementation in Egypt remains underexplored. AIM: This study aimed to assess the association between psychological empowerment and job embeddedness among nurses under the umbrella of the new Universal Health Insurance in Egypt. METHODS: A descriptive cross-sectional design was employed from August 2025 to November 2025. A total of 213 nurses working at Aswan Specialized Hospital, affiliated with the UHI system in Upper Egypt, were recruited. Data were collected using a demographic questionnaire, and psychological empowerment was measured using the Psychological Empowerment Scale, and job embeddedness was assessed using the Global Job Embeddedness Scale. Descriptive statistics, Pearson correlation analysis, and hierarchical linear regression were used for data analysis. RESULTS: = 0.165). In adjusted analyses, the covariates were not independently associated with job embeddedness. CONCLUSION: Psychological empowerment was positively associated with nurses' job embeddedness in the UHI implementation setting. Higher levels of empowerment-related factors were positively associated with greater embeddedness, suggesting their relevance to workforce engagement and retention during health system reform. CLINICAL RELEVANCE: Our study findings highlight that psychological empowerment plays a crucial role in fostering nurses' job embeddedness, which is critical for sustaining workforce retention and stability. Enhancing supportive leadership and nurses' involvement in decision-making is critical, especially during the early phase implementation of the universal health insurance system reform.